The cost of large-scale school health programmes which deliver anthelmintics to children in Ghana and Tanzania
The cost of large-scale school health programmes which deliver anthelmintics to children in Ghana and Tanzania
复制标题
DOI：
10.1016/s0001-706x(99)00028-5
复制
发表时间：
1999-07-30
期刊：
影响因子：
2.7
通讯作者：
Issae, W
中科院分区：
文献类型：
--
作者：
Azene, G;Guyatt, H;Issae, W
有人认为，通过现有的教育基础设施向学童提供驱虫药是控制寄生虫感染的最具成本效益的方法之一。本文探讨了结合使用吡喹酮和肠道线虫使用阿苯达唑大规模治疗血吸虫病和选择性治疗的实际成本，作为学校卫生计划的一个组成部分，达到80442名学生在577所学校在沃尔特地区，加纳，并达到109099名学生在坦桑尼亚的坦加地区的350所学校。分析表明，每名接受吡喹酮治疗的儿童的分娩费用，包括与体重有关的剂量和事先在学校一级进行的筛查，在加纳为0.67美元，在坦桑尼亚为0.21美元，而阿苯达唑的分娩费用，作为固定剂量给所有儿童，在加纳为0.04美元，在坦桑尼亚为0.03美元。加纳的单位费用较高，反映了感染的流行病学情况;总体而言，两国的固定费用相似，但加纳需要治疗的儿童较少。对经济成本（包括无薪工作日的成本）的分析表明，加纳的财务成本增加了78%，坦桑尼亚增加了44%。通过集成到现有的基础设施中，可以避免这些额外的成本。结论是：提供普遍的、标准的、以学校为基础的保健干预措施的基本费用可以低至每名接受治疗的儿童0.03美元;即使提供服务的复杂性略有增加，也会对干预措施的费用产生重大影响;利用教育基础设施确实可以大大节省提供服务的费用。(C)1999 Elsevier Science B. V.保留所有权利。
It has been argued that the delivery of anthelmintics to school-children through existing education infrastructure can be one of the most cost-effective approaches to controlling parasitic worm infection. This paper examines the actual costs of a combination of mass and selective treatment for schistosomiasis using praziquantel and mass treatment for intestinal nematodes using albendazole, as an integral part of school health programmes reaching 80442 pupils in 577 schools in Volta Region, Ghana, and reaching 109099 pupils in 350 schools in Tanga Region, Tanzania. The analysis shows that financial delivery costs per child treated using praziquantel, which involved a dose related to body mass and a prior screening at the school level, were US$ 0.67 in Ghana and US$ 0.21 in Tanzania, while the delivery costs for albendazole, which was given as a fixed dose to all children, were US$ 0.04 in Ghana and US$ 0.03 in Tanzania. The higher unit costs in Ghana reflect the epidemiology of infection; overall, fixed costs were similar in both countries, but fewer children required treatment in Ghana. Analysis of economic costs-which includes the cost of unpaid days of labour-indicates that the financial costs are increased in Ghana by 78% and in Tanzania by 44%. It is these additional costs which are avoided by integration into an existing infrastructure. It is concluded that: the base cost of delivering a universal, standard, school-based health intervention can be as low as US$ 0.03 per child treated; that even a slight increase in the complexity of delivery can have a significant impact on the cost of intervention; and that the use of the education infrastructure does indeed offer significant savings in delivery costs. (C) 1999 Elsevier Science B.V. All rights reserved.